What if Obama and Dems hadn't passed health reform?

As I noted here yesterday, if Republicans take back the House, we will be subjected to some very loud gloating from those who warned Dems that proceeding with health reform would cost them their hard-won majorities because it would surely amount to a suicidal exercise in liberal overreach.

Jonathan Cohn today weighs in with a must-read on this topic, imagining an alternate universe where Dems didn't try to pass reform, and Dems are still facing major losses because a too-small stimulus has left the economy in the toilet:

Mere days stand between the Democrats and a major defeat at the polls. And a lot of analysts think it's because of the way President Obama handled health care. If only Obama had followed up on his campaign pledge to pursue comprehensive reform, rather than postponing action in order to work on the economy, he and his party would be in better shape today. One Sunday morning news pundit, a veteran of public radio, summed it up this way: Americans voted for change but see a president who actually changed very little and couldn't even deliver on his signature campaign promise...

Of course, the second-guessers could be wrong. Imagine for a second that the future had turned out differently -- that, after passing the stimulus, Obama turned to health care reform and made it the centerpiece of his domestic agenda. Maybe the fight would have turned into a fourteen-month-long political boondoggle, helping to turn independents against Washington and allowing conservatives to rally. Maybe the final bill would have included major compromises, leaving the liberal base dispirited. And maybe, after it was all done, Democrats would be likely to lose the House and in danger of surrendering the Senate--with losses even more severe than the ones they face now.

It's possible -- just as it's possible that the outcome of this election actually has very little to do with health care. It could have been determined back in February, 2009, when Obama and his allies settled on a too-small stimulus -- whether out of political necessity or economic misjudgment -- while standing behind necessary but unpopular rescues of the banking and auto industries. The truth about these counterfactuals is that you can never really know what might have been if history had unfolded differently.

One thing is certain, however. Had Obama succeeded in passing health care reform, he would have brought financial security and access to basic care to millions of Americans, while beginning the hard and necessary work of reengineering the health system to make it more efficient. Yeah, the voters might still be really angry. The Democrats might still be on the verge of a historic defeat. But the country would be a lot better off.

To reiterate what I said here yesterday, there's no doubt that health reform has proven more of a liability for Dems than many of us predicted. But this is a topic that deserves far more nuance than your typical "either you're a winner or a loser" Beltway analysis.

There are a host of reasons to believe Dems might have been in a pretty bad position even if they hadn't attempted reform at all. And if that had happened, and Dems had sustained big losses all the same, it could have postponed action on reform for a decade or more. Those who think Dems shouldn't have tried reform this time around need to be asked when Dems would have gotten their next bite at the health care apple -- particularly with such big majorities.

Those folks should also be asked if they really think punting on health reform would have been morally defensible, given that Democrats campaigned on it and given that a just health care system is a core Dem moral imperative. No, these questions are not about who won and who lost or who is up and who is down. But they're still important.

This article by Levin and Ames came out on Feb. 27, 2009, a mere month after Obama was inaugurated. The anti-Obama movement started much earlier than health care reform discussions started to take shape.

They certainly wouldn't have lost as many moderate voters, but even if you could quantify that, there's no way to know if that number would have been completely offset by disgusted liberals who would have sat out Tuesday's vote.

If Obama hadn't (purportedly) signed healthcare reform into law, his chances of getting primaried by a prominent lefty would have gone up though too.

"To reiterate what I said here yesterday, there's no doubt that health reform has proven more of a liability for Dems than many of us predicted."
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You had to know they were going to take a beating on it in the south, midwest and mountain west -- incessant accusations of blue dog "spinelessness" notwithstanding. But I was just reading an article the other day about Gallup's 75th anniversary which happened to note that social security and the New Deal were every bit as unpopular in their time. Fact is, most people hate any kind of change even when they know on some level that it's necessary and inevitable. If they were lighter on their feet about it, they'd all be liberals.

No Greg, you side stepped it yesterday, but can't go on calling this reform. It just is not reform. It is an expansion, possibly an explosion of all that is right and wrong about American health care. It was not a bite at the apple. No one, nobody, not from any quarter thought what we needed to do was make everything stay the same, just much, much bigger.

Took several weeks off from reading the comment boards here, came back today to see the same teabaggers dominating the conversation with spittle filled invective and substance free Beck driven inanity.

Credit must go to Murdoch and Fox News for managing to make America even dumber and more ignorant while simultaneously lining his pockets and those of his favorite Billionaire friends.

Not quite sure what it is about WaPo and Politico comments sections, but they truly invite the lowest of the low quality teabagger commentary.

- throw all sorts of money into Georgia, which would have never been done if Obama had not trashed the campaign finance system

- get Arlen Spector to switch parties

- go through a vote-gathering court process in Minnesota - in which ballots were invalidated and found on a scale unknown in American history

AND then when Ted Kennedy died, they needed the Massachusetts legislature to pass a NEW law to get a temporary appointment

In summary, the 60 votes was not REALLY the will of the people of the country. The People of Pennsylvania elected a Republican.

The extra money Obama had yielded the Senate votes from Georgia and Minnesota.

If Obama had been playing by the rules, he would have never had 60 votes.

Yea, the legitimacy of the 60 votes, especially the temporary appointment in Massachusetts is highly suspect.

In any event, Obama ended up hurting himself.

Obama hurt himself by not finding a compromise health care plan with the Republicans - and yes Obama could have. If Obama had 57 or 58 Senate votes, a much better health care bill, less expensive, would have been the result.

Obama did all this to himself - he is the one who did all these semi-legitimate things - which really were not "change" at all .

You have to have Greasemonkey installed on FireFox, or being using Google Chrome. In both cases, if you're able to use the script, you should just be able to hit the "Install" button on that page, and it will work.

Chrome may have a built in way of editing user scripts, but I don't know what it is. You guys, however, can go look at the source code, paste it into a text editor, edit the users, then save it as "wapo_troll_hunter.user.js" to your desktop. Then go to "Open File" in Chrome, select that file, and it should be self-explanatory from there.

And at the very bottom of the page, BTW, you'll see how many comments have been removed from the current thread (ignore the clipstitch number, that's for troubleshooting, will go away in next version).

Someday China may impose health care reform on this country. Or we may decide, we don't need insane wars, decadent past-times (Las Vegas might disappear!) and accumulating lots of stuff; we may decide we like lots and lots of health care more than piles of stuff and driving around, or driving around with all of the piles of stuff. Every year those RVs get bigger and bigger.

It isn't that we can't afford health care for all. We just can't afford everything we are used to, all that we think is right and normal plus top notch health care for all.

@schrodingerscat: I'm hoping the updating is streamlined. Not sure how that works just yet, but I'm going to try and push out an update (removing the clipstitch comment at the bottom, but leaving the # of comments redacted) in a little bit, and see if you can just update, or if you have to uninstall and then reinstall.

Glad you enjoyed it. I recommend it for anybody who finds the conversation a little more pleasant without threadbombers. I'm also cutting out all the advertising, which isn't anything any adblocker doesn't do, which helps me verify when the script is done. Just FYI. I can pull out the ad blocking if there are any complaints about that, it's just handy while troubleshooting.

jimmy carter is alive and well and commenting here:
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It isn't that we can't afford health care for all. We just can't afford everything we are used to, all that we think is right and normal plus top notch health care for all.

On a separate note, your idea that the stimulus was too small bears some comment. A week ago your colleague EK was writing that same thing, and floating the notion that greatly increased GDP would take care of the greatly increased deficit from borrowing more stimulus money. Today in his column he is lamenting today's GDP number and saying we need more GDP growth.

"At any rate, the economy grew at an annualized rate of two percentage points. That's slow-but-not-catastrophic in normal times. But these aren't normal times. What it means, rather, is that we're not catching up to where we need to be. We'd need a bit of time at 5 percent growth or so to really get back on track."

Even that 2% number is deceptive, because much of it was inventory build.

So here's my question to you. If a stimulus that you and Krugman among others say worked, only produced a deceptive 2% GDP number, how can expect that a much more massive stimulus will spur the GDP further?

It seems very wishful thinking and akin to pouring more money into that non-performing investment because all it need is another push.

Also, please note that I have been kind and not even mentioned currency debasement . . . yet.

Expensive health care plans versus the other things in the Federal budget.

Then you go on - to state that there is a choice between Expensive health care plans and other things that people might want to buy.

Great point.

Right now, Obama is jamming into every health care plan a long list of benefits that everyone has to buy. The option to purchase a stripped-down plan, or even a catotrophic plan I believe is eliminated.

Yea, the American People have to decide what portion of their income they want to devote to health care - and what portions they want for other things.

Apparently Obama is saying no, you can not choose to not pay for health insurance.

AND Obama is saying that everyone has to buy an expensive plan.

Your idea of Vegas disappearing is a good foil - choose Vegas or expensive health insurance.

(As if all the black-jack dealers will suddenly become doctors and all the hookers would suddenly become nurses - but that is a separate issue)

Americans have to choose WHERE their income goes - and a portion of that choice is being taken away. That will hit lower-income people first -

The Middle Class feels threatened by this - they just don't know how far it will lead. And the idea that all their disposable income will vanish into Obama's health care plan is not too far-fetched.

Of course, the solution is to be rich, and not worry about any of this - just sent big checks to the politicians to get your favorite paragraphs inserted into bills.

@JakeD2: "12 posts (including this one) by SolarEnergy, battleground51, and me -- out of 25 total -- that's less than 50%, and certainly not 90%. Deal with it!"

I agree! May I recommend the WaPo Troll Hunter:

http://userscripts.org/scripts/show/89140

You will have to edit the source code a bit to get rid of certain folks, and you might want to keep a note of those, as when I update I'm only going to add sock puppets to the default list, which means you'd have to go back and add anybody you custom added the first time around. I may work on this, I just wanted to get something up to address the primary offender.

skip, good luck and have fun with the American dream time. Top notch health care for all, Xe will fight the wars whenever we get mad, piles of stuff, no problem, all the women are beautiful, all the kids are above average. Don't listen to anyone who says otherwise. Make them prove it ain't so.

I wonder if Greg is aware of what just happened. This brings back one of the original promises (premises) of the original tubes of the Internets. I have to run off and tell my friends who gave up in disgust on comments in general.

So, ah Kevin, are you a genius? If you aren't, can you hazard a guess, why didn't anyone else do this?

@lmsinca: "As I'm not much of a computer wizard, will I have to re-install when he pops up with a new name? Not sure I understand how that works."

I'll have to add it, upload the new script, then let you know. Then you should (in theory) just be able to go to the page and hit "install" and it will update to the latest version--in theory. This is new for me, too.

BTW, this filter works with all the traditional (not The Fix, for example) style WaPo comments. A radical change in formatting on WaPo's part (or even a not so radical change) can/will break the script, so be forewarned. Then I have to update it. Etc.

@shrink: "So, ah Kevin, are you a genius?"

Wouldn't that be nice? Alas, no.

" If you aren't, can you hazard a guess, why didn't anyone else do this?"

For the same reason I hadn't done it before. Nobody in the WaPo comments world wanted to take the time. I'm not a big JavaScript guy, so I have to go look up every step, and it was just a pain the butt. I would have done it much earlier if it was PHP. ;)

Also, often people build preference files and interfaces for this kind of stuff, and I'm just not sure I'm going to do that. I might, but that would involve a lot more work. In any case, anyone can edit the source code. Easier on FireFox than on Chrome, but in both cases people can add or remove redacted commenters by themselves.

in other words, you have no proof:
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skip, good luck and have fun with the American dream time. Top notch health care for all, Xe will fight the wars whenever we get mad, piles of stuff, no problem, all the women are beautiful, all the kids are above average. Don't listen to anyone who says otherwise. Make them prove it ain't so.

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Tell us, shrink2, what does the cost of healthcare have to do with the cost of providing for the physical security of the American citizens?

here's what you're not saying: The government interjected itself into the healthcare industry and now you believe that America faces a "choice" when really no "choice" need be made.

We don't have to chose between the two. We simply have to eject the government from the healthcare industry. Then a free people can spend however much or little they chose on their healthcare.

the underlying assumption is that only the government can provide all these things you mention, when in reality the sole item in your foolish list that is within the government's purview is war-fighting.

As I suspected, no facts, no real insight, just more liberal blather. One either agrees with shrink2 or one winds up on the recieving end of useless diatribes. I now know not to take you any more seriously than the other dogmatically liberal commenters here.

Some folks think having more people insured is a good thing. Those folks should ask themselves what good having an adjuster deny your claim does anyone.
Some folks think "reforming" the system meant subsidies to pharmaceuticals and mandatory bureaucracy, rationing treatment through insurance companies.
The problem isn't people not being insured. The problem is people not having access to medical care, and statistics about people "covered", with a premium here, and a co-pay there, and a bank account required, steady work--statistics fall apart where the rubber meets the road.
Insurance companies are part of the problem. Any reform that keeps them around at all is reform in name only. They are in the business of denying health care, and employ thousands to help them do it. That's the truth, read the stockholders briefings.

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